MEDICARE: JMP STAFFING & AGING AGENCY,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1376101493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JMP STAFFING & AGING AGENCY,LLC

Provider Business Mailing Address
First Line	:	1206 NEWSOME GLENN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-7118
Country	:	US
Telephone Number	:	832-266-4013
Fax Number	:

Provider Business Practice Location Address
First Line	:	1206 NEWSOME GLENN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-7118
Country	:	US
Telephone Number	:	832-266-4013
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PEGUY LUMA
Credential	:
Telephone Number	:	832-266-4013

Provider Enumeration Date	:	06/04/2019
Last Update Date	:	06/04/2019

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